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Common Vision Problems Associated With a Brain Injury

Some 2.8 million Americans suffer a form of TBI every year, which is close to 1 in every 100 people.

Traumatic Brain Injury (TBI) disrupts the normal functioning of the brain due to a strike or jolt to the head. This can cause vision problems, such as blurred or double vision, and difficulty with eye movements, focus, and tracking. This can result in headaches, dizziness and nausea— especially when someone who has suffered a TBI needs to retain focus on a fixed point or task. Over 10 million TBIs occur annually around the world and around 57 million people have been hospitalized for a TBI at some point in their lives.

Studies show that over 90% of Traumatic Brain Injury patients suffer some form of visual dysfunction, yet vision problems tend to be overlooked during the initial treatment of a brain injury. At times, vision problems don’t manifest until some time has passed— so make sure to pay close attention to any vision changes you may experience following a concussion or head trauma. If you notice any alterations in your vision, contact right away. The eye doctor will determine the causes of the vision change and will provide the appropriate vision therapy treatment.

What Kind of Vision Problems Result From a Brain Injury?

female lookingOften the affected person with a TBI is not aware of their specific vision dysfunction but might complain of one or more of the signs below:

Traumatic Brain Injuries tend to interrupt the communication between the eyes and the brain, which can cause a range of visual dysfunctions. The signs often include:

  • Blurred vision
  • Eyestrain
  • Sensitivity to light
  • Reading difficulties
  • Attention and concentration difficulties

Below is a more detailed list of the common vision problems that can result from brain injury or a medical condition, such as a stroke, tumor, aneurysm, meningitis, cerebral palsy, and other neurological insults.

  • Visual Acuity – Blurry vision, either all the time or can shift in and out of focus.
  • Eye focusing – Inability to quickly change focus from near to far objects.
  • Eye teaming – The eyes not working in tandem, potentially causing double vision.
  • Eye movements – Difficulty following a moving object or losing one’s place while reading.
  • Motion sensitivity – The disruption of the connection between vision integration and balance system which makes it difficult to process motion properly. This can cause vertigo or unease when traveling, scrolling a digital device, or when in busy environments such as grocery stores, social settings, or sporting events.
  • Visual Field Loss – The partial or complete loss of peripheral vision. Visual field loss may cause one to bump into objects, be struck by approaching objects, or experience frequent falls.
  • Visual Memory Loss – Losing the ability to recall or remember visual information stored in long or short-term visual memory. This can have a devastating impact on daily functioning as the individual no longer recalls numbers, words, pictures, or any data viewed in the past. Reading comprehension decreases, and the ability to recognize locations and faces declines. One may not remember where a specific object—such as a car key—was put or how to give directions.
  • Headaches or Eye Pain – Following head trauma, the individual may experience a range of headaches or even a stabbing pain around the eye — at times accompanied by redness, burning, or itching of the eyes
  • Sensitivity to Light – In the aftermath of a brain injury, one can develop sensitivity to light and be unable to tolerate glare. Also known as photophobia, sensitivity to light can be exacerbated by particular light sources, such as bright sunlight and fluorescent lighting. LCD screens, used for computers or smartphone devices, can be particularly intolerable after a concussion.

two friends talkingHow Can Neuro-Optometric Rehabilitation Optometry Help You Recover From a Brain Injury?

People of all ages who develop visual dysfunction due to a neurological trauma or injury can benefit from a vision assessment by a Neuro-Optometric Rehabilitation Optometrist (neuro-optometrist). These eye care professionals are highly trained in the diagnosis, treatment and rehabilitation of neurological conditions that affect the visual system, as well as perceptual and motor disorders. Research studies show that patients having undergone a vision rehabilitation program can vastly improve their quality of life.

An interdisciplinary rehabilitation team is essential for patients with concussions, strokes or other neurological deficits. In addition to optometrists, team members may include nurses, physical therapists, occupational therapists, speech-language pathologists, physical medicine doctors, neurologists, neuropsychologists, audiologists, and ophthalmologists, among others.

The regularly assists patients in retraining their visual system to overcome symptoms and visual conditions caused by brain injury. If you are suffering from any of the above symptoms or conditions, please reach out to us.

Post Traumatic Vision Syndrome

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Post-Traumatic Vision Syndrome

An astounding 2.8 million Americans suffer traumatic brain injuries (TBI) each year, of which the majority are mild brain injuries (i.e. concussions). In 9 out of 10 cases, concussions and other traumatic brain injuries result in some degree of visual dysfunction, as nearly half of the brain is dedicated to vision-related processing. The collective symptoms of visual disturbances following a head injury are referred to as post-traumatic vision syndrome (PTVS). Neuro-optometric rehabilitation helps to restore pathways in the eye-brain connection and reduce PTVS symptoms.

If you or a loved one have suffered a traumatic brain injury, contact to learn how neuro-rehabilitation therapy can provide visual recovery.

What Is Post-Traumatic Vision Syndrome?

Trauma to the brain’s cortex stresses the central and autonomic nervous systems. This affects vision and interferes with the visual process and sensory-motor feedback loop.

There are two aspects of vision that, in a healthy person, interact seamlessly for clear vision: central vision and peripheral/spatial vision. Those with PTVS will experience difficulty connecting the two systems, resulting in one or several visual disturbances and symptoms.

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What Are the Symptoms of PTVS?

Even with 20/20 vision, a concussed patient may experience visual dysfunctions, such as:

  • Eyestrain, especially while reading or using the computer
  • Double vision
  • Blurred vision
  • Low blink rate
  • Depth-perception issues
  • Sensitivity to light (photophobia)
  • Difficulty with eye-tracking

Non-visual symptoms include:

  • Headaches
  • Dizziness
  • Difficulty reading
  • Poor balance
  • Difficulty navigating through crowded or tight spaces
  • Visual memory problems
  • Difficulty concentrating
  • Disorientation
  • Driving difficulties

How Does a Neuro-Optometrist Treat PTVS?

Neuro-optometric rehabilitation is the process where a specially trained optometrist helps the patient improve any visual skills that have been reduced due to brain trauma. The neuro-optometrist will diagnose ocular health and assess a wide range of visual abilities, including:

  • Functional binocularity
  • Spatial awareness
  • Visual processing skills
  • Eye-tracking and focusing
  • Convergence
  • Ocular motor function
  • Visual midline shift

After diagnosis, the doctor will formulate a highly personalized treatment strategy that may include the use of specialty lenses, prisms, and other visual aids to rehabilitate vision.

Treatment time ranges from a number of weeks to over a year, depending on the degree of visual dysfunction and patient compliance. Since the visual system is connected with other bodily systems, an interdisciplinary and cooperative approach with other health care professionals is ideal for optimal results.

It’s crucial to get treatment for PTVS as soon as possible to minimize any struggles and regain pre-injury quality of life. For more information or to schedule a consultation, call today.

References

Traumatic Brain Injury Rehabilitation

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Traumatic Brain Injury Rehabilitation

The statistics on TBIs are quite startling. Over 2.8 million Americans suffer a form of traumatic injury each year, which is close to 1 in 100. Traumatic brain injury causes damage to the brain, resulting in headaches, confusion, poor concentration, and vision dysfunctions, among other problems. Fortunately, vision rehabilitation treatment, as part of an integrated team approach, can effectively help in the rehabilitation of patients with traumatic brain injuries.

What Is a Traumatic Brain Injury?

Traumatic brain injury (TBI) occurs when a sudden injury damages your brain. There are two types of TBI: a closed head injury that doesn’t break through the skull (yet may still cause brain damage), and a penetrating head injury, which causes the skull to break.

Approximately 47% of traumatic brain injuries are caused by falls, particularly among young children and those over 65 years of age. Other TBI injuries can result from blunt force trauma (15%), car accidents (14%), and violent physical assaults (9%).

The symptoms experienced following a TBI include headaches, confusion, dizziness, convulsions, poor concentration, memory issues, and personality changes. Because more areas of the brain are used to process vision than any other system, traumatic brain injuries can often result in vision problems.

In order to recover from a TBI, one needs to undergo rehabilitation, which can come in many forms — depending on your specific case and requirements. It may include physical, occupational, and speech therapy, as well as neurological, and psychiatric care. Neuro-optometric rehabilitation, however, is one of the most effective ways to resolve a range of traumatic brain injury vision problems.

Rehabilitation for Traumatic Brain Injuries

kissing wifeDuring its acute stage, moderately to severely injured TBI patients will typically be treated and cared for in the intensive care unit of a hospital. As your needs and abilities change, so will the rehab program. Rehabilitation can take place in various settings, such as inpatient or outpatient rehab hospitals, home-based rehab, day programs, and independent living centers.

What Does Rehabilitation Resemble Following Brain Injury?

Everybody’s needs and functions vary following a brain injury, and each rehab program is designed to match the patient’s unique needs and goals. The program generally includes a case coordinator and several healthcare providers.

The treatments below are offered based on your functions and abilities, such as visual skills, speech ability, mental and behavioral state, language comprehension, among others.

  • Physical therapy
  • Physical medicine
  • Occupational therapy
  • Neuro-optometric rehabilitation
  • Psychiatric and psychological care
  • Speech and language therapy

How Does TBI Affect Vision?

Studies indicate that 90 % of TBI patients experience some form of vision disruption, which is caused by interrupted communication between the eyes and the brain.

Symptoms include:

  • Blurred vision
  • Eyestrain
  • Increased sensitivity to light (photophobia)
  • Reading difficulties
  • Visual periphery defects
  • Color contrast issues
  • Vestibular dysfunction
  • Decreased visual acuity

These visual aberrations may affect professional, educational and other aspects of daily living.

Unfortunately, TBI-related vision problems may often be overlooked during the initial brain injury treatment as visual disruptions may not be present until some time has passed following the accident.

holding handsHow Can an Optometrist Help in the Recovery of a TBI?

Optometrists, who typically work as part of an interdisciplinary team, play a crucial role in treating patients with TBI. Neuro- optometric rehabilitation optometrists (neuro-optometrists) assess and treat TBI-related visual disorders that impact the patient’s rehabilitative progress and quality of life.

At , we see a variety of patients who have had TBI, whether due to a sports injury, motor vehicle accident, or fall, with visual problems range in complexity and severity. By staying on top of the most recent research, can properly tailor a treatment plan to the patient’s unique needs for maximum results.

Two Types of Eye Doctors Specialize in the Detection and Treatment of TBI

Neuro-optometrists

A neuro-optometrist is a Doctor of Optometry (OD) who is highly trained in diagnosing and treating neurological conditions that impact the visual system. The treatment of TBI by a neuro-optometrist is called neuro-optometric rehabilitation (also known as vision rehabilitation).

Neuro-optometric rehabilitation should not be confused with vision therapy, as not all doctors who offer vision therapy are trained in neuro-optometric rehabilitation.

Neuro-ophthalmologist

A neuro-ophthalmologist is a medically trained eye doctor ( MD) who specializes in vision problems relating to the nervous system — such as TBI-related visual acuity loss.

Both neuro-optometrists, such as , and neuro-ophthalmologists can identify TBI-related vision problems. Depending on the type and severity of problems detected, they will develop a treatment plan uniquely designed to eliminate post-TBI vision symptoms and difficulties. Treatments typically include specialized glasses to help with visual processing or in-office and at-home neuro-rehabilitation procedures to reduce symptoms and promote visual recovery.

It is important to note that a single type of vision rehabilitation treatment is often not enough to address all the patient’s needs. That is why an interdisciplinary, integrated team approach can play a vital role in the rehabilitation of patients with traumatic brain injuries.

Neuro-Optometric Rehabilitation for Brain Injuries

Neuro-Optometric Rehabilitation is a personalized treatment regimen for those with visual deficits resulting from traumatic brain injuries, physical disabilities or other neurological issues. The vision complications that develop following a TBI are not related to visual acuity (20/20) but rather to eye teaming, focusing, and tracking. This can result in difficulties in reading and playing sports.

The goal of neuro-optometric rehabilitation is to retrain the visual system and eliminate the visual symptoms that arise from a traumatic brain injury. Fortunately, by using specific eye-training exercises, one can rewire the brain to improve eye function. Just as with other rehabilitation methods, the earlier one starts the eye exercises following a TBI, the better the chance of recovery and sight improvement.

We will use a variety of tools and exercises to train aspects of the visual system in order to improve vision accuracy. The functional skills the doctor will work on will include eye tracking, focusing, and eye teaming, as well as visual discrimination (the ability to discern b’s and d’s), handwriting, and spatial awareness. During the course of the treatment, the patient will be assigned a series of home exercises with specialized equipment. Follow-ups will be regularly scheduled by the optometrist to assess progress.

Should Everyone With a Brain Injury See An Eye Doctor?

If you experience a traumatic brain injury, make sure to see a neuro-optometrist who has special training in TBI-related visual aberrations. This is all the more necessary if you experience any changes in your vision following head trauma.

Children With Traumatic Brain Injury

Though the symptoms of TBI in children resemble those experienced by adults, the functional impact can be very different. Because the brain of a child is in development, a brain injury can result in cognitive impairments. Though not always apparent following the injury, it may manifest itself as the child gets older. Your child may face physical, cognitive, and emotional challenges which can result in struggles for children, their families, schools, and communities.

Therefore, once the child is stabilized following a brain injury, the patient should receive physical therapy, occupational therapy, speech therapy, optometric and neuropsychological testing. Rehabilitation will teach the child how to compensate for impaired or lost functions and will provide strategies on ways to optimize the use of these abilities as they return.

The caring and knowledgeable staff at are always here to help patients experience the best vision care and treatment possible.

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The Role of Neuro-Optometry in the Recovery of Brain Injury and Trauma

A neuro-optometrist, such as , can treat visual, perceptual, and motor problems that may arise following brain injury or trauma, such as a concussion. All too often, the root cause of these symptoms isn’t accurately identified as a visual processing issue— and this may hinder the patient’s ability to recover.

Below is a list of the common ocular conditions that can arise following a brain injury and trauma— all of which can be detected and treated at our neuro-optometric vision rehabilitation center. These include:

  • Vestibular Dysfunction – hypersensitivity to visual motion which is commonly associated with headaches and motion sickness.
  • Acquired Strabismus – also known as “crossed-eyes.” This occurs when the eyes do not align properly. One or both can turn inward, outward, upward, or downward.
  • Convergence and/or accommodative insufficiency – Difficulty paying attention or focusing on near or far objects for long periods of time.
  • Visual-spatial dysfunction/visual processing disorder – a disrupted sense of where objects are in space. Difficulty in detecting differences in shapes or letters.
  • Oculomotor Dysfunction – characterized by issues with balance, reading comprehension and speed, writing, and any other focused visual task.
  • Nystagmus – a condition where the eyes repeatedly make uncontrolled movements. This can result in problems with balance, visual acuity, and depth perception.
  • Post Traumatic Vision Syndrome – may result in reading difficulties (as words will seem to run together), blurry or double vision. Symptoms may not appear for days, weeks, or even months after the incident.
  • Hemianopsia/Visual Neglect—losing half of your visual field from either side.

Reduced Cognitive Functioning for Visual Tasks

The visual perceptual deficits following brain injury or trauma may have dramatic effects on academic, occupational, and even athletic success by negatively impacting:

  • Visual Discrimination – The ability to discriminate the small differences between objects
  • Visual Memory – Retaining a visual record of something observed — a crucial skill for learning
  • Visual Sequential Memory – The ability to remember a string of items such as a grocery list, a phone number, or a combination code
  • Visual Figure-Ground – Difficulty singling out an object among many, such as a car in a parking lot
  • Light sensitivity – Also called photophobia, this is a common condition following a brain injury that makes it unbearable to be outdoors, in a mall, or in a brightly-lit classroom.

These problems and conditions can also result in secondary psychological conditions such as panic attacks and depression.

Fortunately, these are all issues that regularly treats. If you are suffering from any of the above symptoms or conditions, please reach out to us as soon as possible. We regularly assist patients by retraining their visual systems to overcome these challenges, thus helping them get back to doing the things they love.